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Managing chronic diseases in cats

The pet cat population in the United States exceeds the pet dog population, yet the average cat visits the veterinarian only half as often as the average dog.1 Conversely, advancements in feline health care offer us more opportunities to maximize cats' long lives. It's our job to make sure cats receive routine care.

Diagnosing and treating chronic health conditions is one of the most rewarding areas of feline health care. By learning to recognize and treat these conditions, you will deliver higher-quality medicine. The satisfaction of practicing good medicine motivates both veterinarians and support staff members, and clients will feel more bonded to your practice. Here's a look at the most common feline chronic illnesses and recent medical advances.

Figure1. Obesity is one of the most common feline diseases, affecting at least 25% of pet cats.

Obesity
It has been estimated that 25% to 33% of cats are either overweight or grossly obese (Figure 1).2 Yet the 2003 AAHA Compliance Study3 found that veterinarians significantly underdiagnose feline obesity. Cat owners may not recognize obesity or know about the associated health risks, which include diabetes mellitus, hepatic lipidosis, lameness, lower urinary tract disease, and other health problems.

For many feline patients, managing obesity is a lifelong issue. Quantifying obesity is the first step to help both you and the owner recognize the problem. Cats are considered overweight when they are 10% above optimal body weight and obese when they are 20% above optimal weight. Weigh feline patients at every visit and record their body condition scores using a chart such as the Purina 9-point Body Condition System. Optimal body weight is correlated with a score of 5 using the Purina system.

As we better understand cats' nutritional needs, we're better able to prevent and treat feline obesity. For example, we know that carbohydrate-rich, energy-dense diets contribute to feline obesity. Energy-restricted diets may lead to weight loss—but often at the expense of lean body mass. Many veterinarians and cat owners have been frustrated by the poor success rate of traditional high-fiber, low-calorie weight loss diets.

On the other hand, cats receiving high-protein, low-carbohydrate diets can lose weight and maintain lean body mass. Some commercial diets, such as Hill's Prescription Diet m/d, offer high-protein, low-carbohydrate formulations designed for weight management. Research also supports the administration of carnitineat 250 to 500 mg/cat/day in addition to dietary therapy to enhance fat metabolism and weight loss.2,4 Carnitine supplementation is continued for as long as needed to achieve and maintain optimal body weight.

A successful weight management plan starts with calculating the cat's daily food requirement using the manufacturer's feeding guide based on the target body weight. If the cat doesn't lose weight within one month, reduce the dailyportion by 10% to 15% until the cat starts losing weight. Schedule regular re-evaluations to monitor progress and encourage owners to keep a diary of the diet type, amount fed, and body weight over time. Many obese cats will require up to 12 months to reach their target weightsafely, so remind owners that patience and commitment will increase their chances of success.